NAVAL HEALTH CLINIC PATUXENT RIVER (NPI# 1174620926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174620926 |
| Entity Type | Organization |
| Organization Name | NAVAL HEALTH CLINIC PATUXENT RIVER |
| Practice Address |
Bldg 1600 Wilson Drive Indian Head MD 20640 |
| Mailing Address |
National Naval Medical 8901 Wisconsin Ave Bethesda MD 20889-0001 |
| Practice Telephone | 4107444904 |
| Practice Fax Number | 4107444361 |
| Mailing Telephone | 4107444904 |
| Mailing Fax Number | 4107444361 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC PATUXENT RIVER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2037300 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902905318 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1370, Patuxent River, MD 20670 | 2006-09-22 |
| 1003915133 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Branch Medical Clinic Bldg 192, Dahlgren, VA 22428 | 2006-09-22 |
| 1659470078 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1370, Patuxent River, MD 20670 | 2006-09-22 |
| 1922044460 | Naval Health Clinic Patuxent River | Clinic/Center | 47149 Buse Rd, Bldg 1370, Patuxent River, MD 20670-1540 | 2006-06-22 |
| Street Address |
BLDG 1600 WILSON DRIVE |
| City | INDIAN HEAD |
| State | MD |
| Zip Code | 20640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639664683 | The Heard Group, LLC | Clinic/Center | 6284 Hard Bargain Cir, Indian Head, MD 20640 | 2018-06-22 |
| 1154790509 | Memuna Kamara | Nurse Practitioner | 319 Munahan Circle Unit A, Indian Head, MD 20640 | 2015-09-16 |
| 1861494395 | Dale R Harman | Preventive Medicine | 1600 W Wilson Rd, Occupational Health Clinic, Nswc Indian Head, Indian Head, MD 20640-1400 | 2005-08-15 |
| 1467414508 | Keith Lynn Mayberry | Dentist | 1600 W Wilson Rd, Indian Head, MD 20640-1400 | 2006-04-04 |
| 1588646962 | John H Callahan | Physician Assistant | 17 Strauss Ave, Indian Head Division, Indian Head, MD 20640-1523 | 2005-11-18 |
| 1114064573 | Monica L Bilik | Physician Assistant | 101 Strauss Ave Bldg 901, Indian Head, MD 20640-1542 | 2007-02-01 |
| 1881654697 | Kevin F Kelley Sr. | Physician Assistant | 101 Strauss Ave, Cbirf, 2nd Mef, Indian Head, MD 20640-1542 | 2006-03-24 |
| 1750561189 | Dexter Arvange Woods | Dentist | 158 Riverwatch Dr, Indian Head, MD 20640-1558 | 2007-11-14 |
| 1649818907 | Augustina O Boadu | Non-emergency Medical Transport (VAN) | 32 Fairhill Ln, Indian Head, MD 20640-1577 | 2019-12-18 |
| 1154692630 | Rebecca I Frank-hogren | Social Worker | 36 Poplar Ln, Indian Head, MD 20640-1601 | 2012-01-16 |
| Find all providers in zip 20640 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273195 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162 | 2019-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868870 | Walter Reed National Military Medical Center | Military/U.S. Coast Guard Pharmacy | 101 Buchanan Rd, Annapolis, MD 21402-5107 | 2020-10-09 |
| 1063763241 | National Naval Medical Center | Military/U.S. Coast Guard Pharmacy | 8901 Wisconsin Ave Dept Ofphcy, Bldg 9, Room 2303, Bethesda, MD 20889-0001 | 2012-09-27 |
| 1902905318 | Naval Health Clinic Patuxent River | Military/U.S. Coast Guard Pharmacy | Bldg 1370, Patuxent River, MD 20670 | 2006-09-22 |
| 1679672083 | Dunham Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 1452 Porter St, Ft Detrick, MD 21702 | 2006-09-22 |
| 1851490270 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1050 W Perimeter Rd # D1119, Jb Andrews, MD 20762-6601 | 2006-09-22 |
| 1265539019 | Malcom Grow Medical Center 79 Mdg Mdss Sgsr | Military/U.S. Coast Guard Pharmacy | 1 San Diego Loop Bldg 3188, Jb Andrews, MD 20762-5518 | 2006-09-20 |
| 1205242310 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 1434 Porter St, Frederick, MD 21702-9254 | 2014-07-09 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| 1518379395 | Malcolm Grow Medical Clinic 779 Mdg | Military/U.S. Coast Guard Pharmacy | 1060 W Perimeter Rd, Joint Base Andrews, MD 20762-6602 | 2014-05-28 |
| 1417369299 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | Kirk U.S. Army Health Clinic, Bldg. 2501 Oakington Street, Aberdeen Proving Ground, MD 21005-5163 | 2014-05-28 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN HEAD |
| Zip Code | 20640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.